Healthcare Provider Details

I. General information

NPI: 1306188750
Provider Name (Legal Business Name): ERIN MCCORMICK D.V.M.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2013
Last Update Date: 08/08/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

755 CAPITAL DR SW
CEDAR RAPIDS IA
52404-8949
US

IV. Provider business mailing address

755 CAPITAL DR SW
CEDAR RAPIDS IA
52404-8949
US

V. Phone/Fax

Practice location:
  • Phone: 319-841-5161
  • Fax:
Mailing address:
  • Phone: 319-841-5161
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174M00000X
TaxonomyVeterinarian
License Number090010822
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code174M00000X
TaxonomyVeterinarian
License Number7830
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: